Talking to your doctor about hormone therapy

At Women’s Health Network, we talk with many women
who are frustrated with their medical care, especially when it comes to discussions
of hormonal imbalance and hormone replacement therapy.
Women who are suffering from hot flashes, irritability, sleep disturbances, forgetfulness,
anxiety, and more are often told that their hormones are “fine,” or they’re given
prescriptions for hormone replacement therapy (HRT) or antidepressants, often without
any discussion of drug risks or alternatives. Other women who are interested in
HRT are confused about risks and benefits of synthetic hormones versus ‘bioidentical’
hormone therapy, but aren’t always getting their questions answered.

When something is off with our bodies, we want to talk it over with our healthcare
practitioners. But if these conversations are discouraging or, worse, nonexistent,
we’re left without the critically important information we need to feel better,
and we don’t know where to turn for help. Our approach can help you foster a fruitful
conversation with your doctor about hormone therapy and your alternatives.

Know where your doctor is coming from

Our goal is to help you find a health provider who will partner with you to create
the best possible path through this potentially challenging period in your life,
i.e., menopause. Remember that all healthcare providers are human. They have spent
many years learning to be experts in their field and even more years practicing
their expertise. They went into medicine to help people, but are also overstressed
these days by managed care rules, financial considerations, and having to work as
quickly as possible. He or she probably also did not get much training in sex hormones
(female or male). (Only recently have many hospitals even started women’s health
programs.)

We also want to help you understand the complexities
of hormone therapy. HRT is still the gold standard for treating menopausal
symptoms. However, HRT has been the subject of wide debate since the 1970s, and
your doctor may be just as confused as you are. Both media headlines and drug companies
have bombarded doctors with conflicting arguments about HRT and alternatives. Many
practitioners are still wary of prescribing hormone therapy ever since large studies
like the Women’s Health Initiative reported increased risks of breast cancer, coronary
heart disease, stroke and venous thromboembolism in menopausal women using conventional
HRT. “Bioidentical” hormones are made from plants and match the chemical structure
of your own hormones. Although bioidentical HRT is safer in many ways than conventional
HRT, most doctors don’t have experience with it, or they simply place more trust
in synthetic hormones because they’ve been so thoroughly tested.

Is hormone therapy dangerous or not?

Many different factors determine the risk/benefit ratio in menopausal women using
HRT. Some of these factors have to do with the hormones themselves. Various effects
of HRT can depend on:

the form of the hormones (synthetic versus bioidentical)

the route of administration (oral versus topical, or transdermal)

the dosage

the length of treatment

Conventional HRT typically consists of “conjugated equine estrogens,” or CEEs (e.g.,
Premarin) and – if a woman still has her uterus – medroxyprogesterone acetate, or
MPA (e.g., Provera); the combination of the two is called Prempro. CEEs are made
from pregnant mares’ urine; hence, they’re natural to horses but not to us! CEEs
are also much more likely than bioidentical hormones to break down into an compound
that damages DNA in breast tissue. MPA is given along with estrogens to protect
a woman’s uterus. However, it’s entirely synthetic and is responsible for much of
the disease risk that has been observed in women using conventional HRT. Because
CEEs and MPA are taken orally, they must first travel to your liver where they can
activate pro-coagulation proteins, increasing the risk of clot formation, ischemic
stroke and thromboembolism. This doesn’t happen with transdermal hormones, since
they bypass the liver.

Because we’re all unique in terms of our genetic make-up and individual health problems
and risks, the typical one-size-fits-all approach to HRT is asking for trouble.
Individual factors that can influence the safety of HRT include:

Your age

Your weight and body mass index (BMI)

Family history, e.g., of breast cancer or cardiovascular disease

Genetic susceptibilities

Environmental stressors

Alcohol intake

Are you beginning to see why the question of whether to use HRT or not a simple
one? Ideally, your healthcare practitioner will fully evaluate your unique set of
risk factors, including genetic make-up, environmental factors, and underlying health
problems that might make HRT more risky (e.g.,
breast cancer risk) or more helpful (e.g., osteoporosis prevention). If
you decide to use HRT, the safest forms and doses should be used, and you should
be regularly monitored over time for any emerging problems.

Know your body, your menopause symptoms and your medical history

We suggest assessing your symptoms to figure out what’s bothering you most before
visiting your doctor. Your worst symptom may be insomnia, moodiness, hormonal weight
gain, hot flashes, or something else. Doctors are taught to first ask for a patient’s
“chief complaint,” then take a history — when, what, how, where, etc. Unfortunately,
with managed care time constraints, a full discussion often fails to take place.
So, be prepared and you’ll get more out of the visit.

Here’s some information to gather prior to your appointment:

A list of your symptoms, with the most bothersome at the top

Your own past medical history and your family medical history

A list of your prescriptions and supplements

Notes about your ideal approach to menopausal symptoms, and what feels realistic
for your life (i.e., Do you like to take a more natural approach to your health?
Are you willing to make changes in your diet and in your lifestyle? Are you interested
in bioidentical hormones?)

When you are ready to call for your appointment, specifically request a "hormone
consultation." Ask for an appointment of at least 15 to 30 minutes. Having a “hormone
consultation” should be the sole focus of your visit, and you deserve to stay comfortably
dressed in your clothes instead of having to wear a “johnnie” and sit on an exam
table. Be sure to schedule your check-up after the consultation, or on another day,
if necessary. This type of focused consultation appointment makes it easier to say
what you want to say without being rushed or distracted by other topics.

Know what you are asking for — options for menopause symptom relief

We encourage you to do some research on your choices prior to meeting with your
healthcare provider. The chart below lists the pros and cons of some of your options
for menopausal symptom relief. If you’d like more detail on large hormone studies,
please see our article Findings
on HRT since the Women’s Health Initiative.

With a combination product, adaptogenic herbs can each work together within the
cells, supporting only what your body needs

Herbs generally work in ways other than changing the levels of hormones

It may take some time before you notice symptom relief

Herbs work best in combination with dietary & lifestyle factors

Diet and lifestyle changes

Hormonal balance is improved by include adding protein to every meal, cutting back
on sugar and alcohol, adding more vegetables, taking a multivitamin/mineral, getting
enough sleep, and carving out more regular time for relaxation and self-reflection

Feeling your best usually takes more than just a prescription. We recommend trying
the most natural, least invasive steps first to create a foundation of health and
hormonal balance, and then gradually adding remedies, as needed. We formulated Herbal
Equilibrium to help balance estrogen, progesterone and testosterone and
to relieve the top 10 symptoms of menopause. For a more comprehensive approach,
our Hormonal Health Program includes a hormone-healthy diet and lifestyle guide
(with recipes!), a rich multivitamin, Omega-3 fatty acids, Herbal Equilibrium, free
phone support and exclusive webinars. We also have a program to help women wean
themselves off of HRT. No matter what you choose, you have support from Women’s
Health Network.

100% satisfaction guarantee — we guarantee
you will be fully satisfied and feel the way you want to feel. If you don’t,
just let us know within 60 days after the purchase of a Program or product and you’ll
receive a prompt refund of your purchase price, minus shipping and handling, when
we receive the product back, even if you’ve taken all the supplements.

No obligation — There is never any purchase
commitment, even if you join our convenient automatic resupply program. You may
cancel at any time by calling us at 1-800-448-4919.

Customer service done right — We have real
women available to answer your calls and e-mails. Plus a great online interface
where you can control almost every aspect of your relationship with us.

Your health and happiness are our mission. If you have suggestions about how we
might improve what we do — with our products and programs, in serving you,
or on our website — please e-mail us at support@womenshealthnetwork.com. If
you want to find out more about our approach, please call us at 1-800-448-4919.
We’re here to listen and help.